Tag Archives: Miami

Geographic cost differences of more than $6,000

Healthcare costs differ from one region to the next. This year’s Milliman Medical Index (MMI) once again illustrates this variation by examining 14 cities. Miami is the most expensive city studied, at $24,965, while Phoenix is the least expensive, at $18,365.

Miami has been the most expensive city for several years, which caught the eye of the Miami Herald. Here is an excerpt:

The Miami area continues to have the highest healthcare costs in the country, according to the latest edition of the Milliman Medical Index…

The number include employer and employee costs, including some out-of-pocket deductibles and co-pays.

For years, the Miami region has ranked at or near the top of costs for Medicare, with seniors here often costing twice as much a year as those in places like Salt Lake City or Minneapolis-St. Paul, according to studies by Dartmouth doctors…

Dartmouth has long attributed the high costs in Miami to the area’s large numbers of specialists and an over-supply of hospital beds.

How do these costs vary across the 14 cities analyzed in the MMI? Here is an illustration:

Take another drive in my Cadillac

Paul Krugman weighed in over the weekend on the Cadillac tax:

Should there be a limit to the tax deductibility of employer-provided health insurance, which is what the excise tax in the Senate bill is supposed to fix? My answer is yes, but the final bill should address the criticisms….The counter-arguments seem to run along three lines. First, there’s the argument that many “Cadillac” plans aren’t really luxurious — they reflect genuinely high costs. That’s surely true. A flat dollar limit to tax deductibility has real problems. At the very least, the limit should reflect the same factors insurers will be allowed to take into account in setting premiums: age and region.

What effect do age and location potentially have? Bob Dobson’s paper, “No Room to Stand,” looks at how South Florida is susceptible to the Cadillac tax.

In 2009, the cost of healthcare for a typical family of four in Miami covered by an employer-sponsored PPO is $20,282. The cost of care for a similar family in Phoenix is less than $15,000. While these numbers include employee cost-sharing (copays, deductibles, and other coinsurance are reflected in the MMI totals but are not subject to the excise tax), they still show how much more susceptible certain areas of the country are to hitting a fixed-dollar excise tax threshold such as $21,000. Given that medical costs have trended upward at a rate of between 7% and 10% over the last five years, one is left to wonder if the average Miami family will find its benefits exceeding the tax-triggering ceiling by the time the tax provision is imposed in 2013.

We have blogged about this before. You can read the Dobson report here.

South Florida Cadillac

We’ve blogged before about the healthcare costs in Miami. An article in today’s Miami Herald looks at the possiblity that many health plans in South Florida may trigger the proposed tax on “Cadillac” benefits if such a tax is included in reform proposals. Excerpting from the article:

Santiago Leon, a Miami insurance broker, says that in South Florida “we have on the market today a surprising number of plans that would hit the `Cadillac’ ceiling.”

About a third of the 11,000 employees of Baptist Health South Florida have a plan valued at more than $17,000 a year. Considering that health costs are rising far faster than inflation, it’s possible those figures could be above the threshold of $21,000 in 2013, when the provision would be scheduled to take effect.

Meanwhile, Milliman, a national consulting firm, released a study earlier this year that an average employer-based, preferred provider organization plan for a family of four in the Miami area cost $20,282 in 2008.

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More heat in the Sunshine State

Did you know Miami-Dade County has two Gamma Knives, and will host a proton beam by 2012?

So reports an article just out from Forbes. The article looks both at the cost of care in Miami as well as some of the drivers. Quoting from the article:

Though Miami-Dade’s share of residents 65 and older accounts for 14% of the population, that doesn’t explain why it topped the institute’s list. An annual report by the actuarial and consulting firm Milliman found that Miami had the highest level of private sector medical spending among 14 major metro areas studied. According to the firm’s analysis, it costs $20,282 for a family of four covered by an employer-sponsored preferred provider organization (PPO) compared to a national average of $16,771.

Just yesterday we mentioned efforts to counter Florida’s healthcare costs with a new doctor model, one of several attempts to address some of the highest-cost care in the country.

For the national view on cost disparity, check out this new tool from the New York Times.